妊娠合并梅毒患者围产预后因素探讨

The clinical analysis of 50 patients with pregnancy complicated syphilis

目的探讨影响妊娠合并梅毒患者围产儿预后的因素。方法以我院2008年1月-2012年11月收治的妊娠合并梅毒患者50例作为临床研究对象,所有患者确诊后立刻给予治疗。观察不同孕期治疗、不同药物及RPR滴度对妊娠合并梅毒患者围产儿预后的影响。结果 (1)12孕周之前治疗组的围产儿死亡率和先天性梅毒发生率均低12孕周之后治疗组,差异有统计学意义(P<0.05);(2)母血清RPR滴度≤1:8患者的早产率,围产儿死亡率及先天梅毒发生率均低于滴度≥1:16患者,差异有统计学意义(P<0.05);(3)青霉素治疗组围产儿死亡率及先天性梅毒的发生率均低于红霉素治疗组,差异有统计学意义(P<0.05)。结论青霉素治疗是防止妊娠合并梅毒发生先天性梅毒及降低围产儿死亡率的有效治疗手段,早诊断早治疗可以有效改善妊娠合并梅毒患者的围产儿预后,对于改善人口素质具有重要意义。

Objective To analyse the factors that affect the perinatal prognosis of patients with pregnancy complicated syphilis. Methods We selected 50 patients who had pregnancy complicated syphilis as research objects from January, 2008 to November, 2012 in our hospital. All the patients were treated promptly once diagnosed. To analyse the the influence of different type of drugs, RPR titer and the therapy in different pregnant period on the perinatal prognosis of patients with pregnancy compli-cated syphilis. Results （1） The perinatal mortality rate and the birth of congenital syphilis baby of patients treated before 12 week pregnancy was lower than which treated after 12 week pregnancy, The variation had statistical significance （P〈0.05）.（2）The prema-ture birth rate , perinatal mortality rate and the birth of congenital syphilis Baby of patients with RPR titer in less than or equal to 1：8 was lower than the patients with RPR titer in greater than or equal to 1：16. The variation had statistical significance（P〈0.05）. （3）The perinatal mortality rate and the birth of congenital syphilis Baby of patients treated with penicillin was lower than ery-throcin. The variation had statistical significance（P〈0.05）. Conclusion Penicillin therapy is an effective means of preventing inci-dence of children with congenital syphilis and reducing the perinatal mortality rate. Furthermore, early diagnosis and treatment can effectively ameliorate perinatal prognosis of patients with pregnancy complicated syphilis. It has important implications for improve population quality.